A Reluctant Defense of Pro-Ana Blogs

A recent survey has found that people with eating disorders may get more positive help from pro-ana communities than anyone realized. I'm arguing why banning these communities outright is a bad idea.

Aug 21, 2012 at 4:00pm | Leave a comment

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The only ribs I'm interested in come on a plate.

A new study into the hoary underworld of pro-anorexia bloggers has discovered the unexpected: pro-ana communities may not exclusively be the dark pits of self-destruction they are typically assumed to be. The survey, conducted by researchers from Indiana University, suggests rather candidly that pro-ana communities may provide better support than traditional eating disorder treatments, and that said communities even continue to provide assistance to those who have decided to begin recovery. 

"They use the blogs to look for support and understanding, but at the same time, the content that they display is something for us -- people who are not sick -- very disturbing," [lead author Daphna Yeshua-Katz] said. "Studies show that people with eating disorders are stigmatized. Therefore these bloggers are looking for a place to vent out and express themselves without judgment of others."

[...]

"The results revealed that the answers to why individuals are attracted to pro-ana sites have little to do with the need to share a broad philosophy or outlook and may stem from the desire simply to belong to a safe community of individuals with similar experiences," the researchers wrote in the study.

Their primary motivation for blogging was to seek social support. Most bloggers started publishing because they did not want to feel alone and were interested in finding others like themselves. They described interactions with family and friends as stressful "because they lack the understanding of their situation, while online they receive support constituted with sympathy, understanding and encouragement."

Shame and eating disorders are inextricably linked; shame is nearly always the spark that first lights the ED fire, and then shame is the fuel that feeds it. Contrary to common assumptions, the shame does not necessarily have to be related to body size, shape or appearance; often eating disorders evolve as a coping mechanism to help sufferers manage other issues in their lives. 

There are a vast number of risk factors for eating disorders unconnected to body esteem. For example, eating disorders are more likely to happen in people who have anxiety disorders, obsessive-compulsive disorder, avoidant personalities, or narcissism. Childhood sexual abuse is a well-established risk factor for eating disorders; one study found that people with post-traumatic stress disorder (stemming from a nonspecific trauma) are three times as likely to develop bulimia as those without PTSD. 

The point here is not that people with eating disorders are wildly messed-up individuals; there are also plenty of sufferers for whom only one of the primary risk factors -- simply being female -- is enough. The point is rather that eating disorders and the people who have them are complicated, and as complicated as they are, the one thing they do tend to have in common is an excess of shame. Eating disorders are inspired by it, and then they are sustained by it, and this shame is also what can make EDs so difficult to diagnose and treat.

Pro-ana communities have been roundly condemned by media coverage in recent memory; sites like Pinterest and Tumblr have even taken action to shut down “thinspiration” boards and blogs, where pro-ana participants inspire and support one another both in continued weight loss and in tips and tricks for keeping their disorder hidden from concerned family and friends, thereby managing (and yet also sustaining) the stress of having what is essentially a secret double life. 

The media coverage has portrayed these communities as dangerous and evil, in which people advocate in favor of eating disorders as a valid lifestyle choice for everyone, but of the surveyed bloggers in the Indiana University study, only 10% called pro-ana a “lifestyle,” with the rest identifying it as a mental illness or a coping mechanism, and many made efforts to deter non-disordered individuals from accessing their blogs.

I’d wager that at least part of the reason we’re so comfortable condemning pro-ana sites is because many of us still wrongly think of eating disorders as something a person both begins and continues as a conscious, willful choice -- the solution to which is to simply eat like a “normal” person, as though the disorder is a switch to be flipped on and off. 

This stigma adds to the shame of eating disorders, which adds to communities of sufferers being driven underground, which adds to their shame, which some will then combat by attempting to “reclaim” anorexia as a reasonable diet, which then makes the media go bananas with horror and pressure sites like Pinterest and Tumblr to shut these rib-loving starvation circles down. Which sends them further into the shadows, which increases the shame and difficulty in being honest about this illness in public life... you see how it goes on and on. 

Mental illness is already sufficiently stigmatized; eating disorders often don’t even get their due respect as valid mental illnesses. The urge for secrecy is hardly surprising.

I was never formally diagnosed with an eating disorder myself, but I suspect at certain points of my life I would have qualified under the relatively new EDNOS heading. EDNOS stands for “eating disorder not otherwise specified,” and it first appeared in the 1980 edition of the Diagnostic and Statistical Manual of Mental Disorders, aka the DSM, the bible by which much of American psychology lives and breathes. At the time EDNOS was intended to be only employed in extreme and unusual cases that failed to meet all the necessary criteria for anorexia or bulimia. Since then, it has come to represent 43% of all eating disorder diagnoses, making it the most common ED around.

This probably says more about the brokenness of the current standards for eating disorder diagnosis than it does about any growth in eating problems, but still.

During my most intense dieting years, in which I was doing a lot of severe restriction, I also did a lot of secret eating. At the time I thought of this as “bingeing” but as an adult who has since had conversations with real bingers, what I was doing didn’t even begin to qualify. However, like many ED sufferers, I kept hidden stashes of food in my room. Boxes of cereal under my bed. A loaf of rye bread on the top shelf of my closet. Granola bars in my bottom drawers. I ate things in the privacy of my room, late at night when I knew I wouldn’t be disturbed, for two reasons: one, I was honestly hungry from dieting all the time, and two, because I was rebelling against the ridiculous diets I had put myself on, rebelling against the shame I’d come to feel any time I put anything, no matter how innocuous or how miniscule, into my mouth.

That shame kept me from a reasonable relationship with food and eating for many years, and it’s the primary reason why I am so outspoken today on body matters. Because shame around our relationships with our bodies and how we feed those bodies is a poison. It doesn’t motivate us, it keeps us sad and small and still.

I’ll stop short of advocating in favor of pro-ana communities (and way short of supporting EDs themselves), but I do think that in light of this admittedly small study, we ought to reassess how we talk and think about eating disorders, and the people who live with them. 

ED sufferers are both discovering and building the pro-ana underground out of a need to have a space in which their illness is understood and their experiences are shared -- a need to feel less alone. They’re sticking with them even through recovery for the same reasons, because it is the one place where they can be honest about their issues without feeling ashamed or humiliated by them. Maybe they can even feel a bit of pride. The pride, like the behavior, may ultimately feed a destructive impulse, but that doesn’t mean the solution is to bury these communities further, and reaffirm their members’ beliefs that there is no where else that they can go to be understood.

Pro-ana blogs and communities are hardly rainbows and kittens all the time -- they can be, without a doubt, dangerous tools for inspiring and perpetuating eating disorders that can lead to long-term health problems, if not death. But problematic though they may be, it seems that they may also be doing some things right. Either way, the outright banning of pro-ana sites does not make eating disorders vanish, and likely only contributes to already significant shame and stigma. It's not a solution. I think instead we may have a few things to learn from the continued success of these communities as unconditional support systems for both illness and recovery, even in the face of efforts to erase their existence.

If only we can kill the stigma and judgement imposed on those who discuss their eating disorders openly, these communities will cease to be necessary. And that would be a more constructive beginning to addressing the problem.